Discipline or dismissal awaited whistle-blowers

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WASHINGTON — Staff members at dozens of Department of Veterans Affairs hospitals across the country have objected for years to falsified patient appointment schedules and other improper practices, only to be rebuffed, disciplined or even fired after speaking up, according to interviews with current and former staff members and internal documents.

The growing VA scandal over long patient wait times and fake scheduling books is emboldening hundreds of employees to go to federal watchdogs, unions, lawmakers and outside whistle-blower groups to report continuing problems, officials for those various groups said.

In interviews with The New York Times, a half-dozen current and former staff members — four doctors, a nurse, and an office manager in Delaware, Pennsylvania and Alaska — said they faced retaliation for reporting systemic problems. Their accounts, some corroborated by internal documents, portray a culture of silence and intimidation within the department and echo experiences detailed by other VA personnel in court filings, government investigations and congressional testimony, much of it largely unnoticed until now.

The department has a history of retaliating against whistle-blowers, which Sloan D. Gibson, the acting VA secretary, acknowledged this month at a news conference in San Antonio.

“I understand that we’ve got a cultural issue there, and we’re going to deal with that cultural issue,” said Gibson, who replaced Eric K. Shinseki after Shinseki resigned over the scandal last month. Punishing whistle-blowers is “absolutely unacceptable,” Gibson said.

The federal Office of Special Counsel, which investigates whistle-blower complaints, is examining 37 claims of retaliation by VA employees in 19 states, and recently persuaded the VA to drop the disciplining of three staff members who had spoken out. Together with reports to other watchdog agencies and the Times interviews, the accounts by VA whistle-blowers cover several dozen hospitals, with complaints dating back seven years or longer.

Dr. Jacqueline Brecht, a former urologist at the Alaska VA Healthcare System in Anchorage, said in an interview that she had a heated argument with administrators at a staff meeting in 2008 when she objected to using phantom appointments to make wait times appear shorter, as they had instructed her. She said that the practice amounted to medical fraud, and she complained about other patient care problems as well.

Days later, a top administrator came to Brecht’s clinic, put her on administrative leave, and had security officers walk her out of the building.

“It’s scary to think that people can try to stand up and do the right thing, and this is the reaction,” said Brecht, now in private practice in Massachusetts.

Her complaints were corroborated by other Alaska personnel and were the subject of an email that Brecht sent to a military doctor at the time. Brecht wrote that administrators “schedule fake patient appointments (i.e. commit FRAUD).” They do so, she wrote, “just so our numbers look good to DC (and the administrators get their bonuses for these numbers).”